MCG care guidelines provide fast access to evidence-based best practices and care-planning tools across the entire care journey, supporting clinical decision-making and documentation as well as …

Mar 4, 2025 · Updates in the 29th edition of the nationally recognized guidelines were driven by recent regulatory changes in Medicare Advantage, new diagnoses with criteria for observation care, and …

Jul 1, 2025 · The 29th edition of MCG’s Care Guidelines is now available for providers to use when submitting authorization requests. The technical issue that delayed the implementation of the latest …

Feb 17, 2025 · New guidelines have been added to self‑management and low‑intensity disease management pediatric guidelines. If you have questions, please contact Provider Services at …

The latest edition of the Milliman Care Guidelines is now available. This updated version reflects the most recent changes and best practices in clinical guidelines.

The below tables highlight new guidelines and changes. Updates marked with an asterisk (*) notate that the criteria may be perceived as more restrictive.

MCG Health provides the industry’s leading evidence-based guidance and technologies to optimize health outcomes, drive operational efficiency, and achieve cost savings. MCG is considered the …

Effective June 1, 2025, Blue Cross NC will upgrade to the 29th edition of MCG Care Guidelines for the following modules. Below is high level summary of the updates and is not intended to be all inclusive:

To assist in your organization’s alignment with the Final Rule, MCG has added Criteria, Rationale, and Related CMS Coverage Guidance sections to many care guidelines.

Effective June 1, 2025, Healthy Blue will upgrade to the 29th edition of MCG Care Guidelines for the following modules. Below is high level summary of the updates and is not intended to be all inclusive: